| Doctor Name: | RYAN C HUBBARD |
| NPI Number: | 1700141520 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | D.O. |
| License Number: | 1066 |
| Business Practice Address: | 650 Joel Dr Fort Campbell, KY - 422235318 |
| Business Phone Number: | 2707988106 |
| Business Fax Number: | |
| Mailing Address: | 650 Joel Drive, FORT CAMPBELL |
| State: | KY |
| Postal Code: | 42223 |
| Phone Number: | 2707988106 |
| Fax Number: | |
| NPI Enumeration Date: | 07/09/2012 |
| NPI Last Update Date: | 11/14/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 1066 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NE |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |